The landmark Nursing Home Care Reform Act of 1987 mandated basic standards of care to ensure the physical, mental, and psychosocial well-being of residents. Yet little has changed since it was enacted. High-quality facilities continue to provide good care, while poorly operated ones remain substandard. This volume offers an evidence-based framework for improving care in nursing homes. Taking a broad perspective, the authors review the history, development, and current state of care in nursing homes. After defining the concept of "quality" in the home, they assess an array of qualitative and quantitative statistical data to identify inconsistencies found among U.S. facilities. Individual chapters focus on varied aspects of care and the ways in which it is measured, including a thorough review of such key mechanisms as the Online Survey, Certification, and Reporting (OSCAR) data network and the Structure-Process-Outcome (SPO) model. The book also examines specific factors related to measuring and improving care, including government encouragements and sanctions, staffing policies, and the integration of technology into practice. Throughout, the authors give recommendations grounded in sound methodology and real-world experience. This service-oriented guide supplies vital tools, informed tips, and provocative ideas for professionals, students, and policy makers involved in gerontology and geriatrics.